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In my own practice, especially if an older person has risk factors for vitamin B12 deficiency, I consider a vitamin B12 level of 200-400 pg/mL borderline, and I usually order a methylmalonic acid level as a follow-up

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This is especially important for patients with absorption issues such as those with digestive conditions, low stomach acid (common with aging), or MTHFR gene variants who cannot adequately absorb B12 from food or oral supplements

A common protocol involves administering 1,000 mcg of B12 weekly for 4 to 8 weeks, depending on the deficiencys severity and the patients response

Peptides are short chains of amino acids that act as biological messengers in the body